© 2002 by Oxford University Press
Journal of the National Cancer Institute, Vol. 94, No. 21, 1603,
November 6, 2002
© 2002 Oxford University Press
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Recruitment Begins for Lung Cancer Screening Trial
The National Cancer Institute has launched a study to determine whether screening current and former smokers with spiral computerized tomography (CT) or chest x-ray can reduce their risk of dying of lung cancer.The study, called the National Lung Cancer Screening Trial (NLST), will enroll 50,000 people at 30 sites throughout the United States. Patients in both screening groups will be screened once a year for 3 years, and all participants will be monitored until 2009.
"The single most important thing that we are analyzing in the NLST is the difference between the CT and the chest x-ray arms in the numbers of deaths from lung cancer," said Denise Aberle, M.D., co-principal investigator of the trial and professor and chief of thoracic imaging at the University of California at Los Angeles. But, she added, there are a number of other important end points, including the impact of screening on smoking behavior, the emotional impact of a positive screening test, and the costs of screening.
There is no evidence from clinical trials that either screening technique for the early detection of lung cancer saves lives. A few small trials of screening with chest x-ray found no reduction in mortality, but further analyses found that these trials were too small to adequately test the procedure, said John K. Gohagan, Ph.D., chief of NCI’s Early Detection Research Group.
Spiral CT is a relatively new screening tool that allows doctors to create a 3-dimensional model of a patient’s lung by combining cross-sectional x-ray images of the lungs. Although spiral CT can detect tumors at a smaller size than chest x-rays, researchers do not know whether detecting tumors at a smaller size increases a patient’s chances of survival.
"We don’t have any accepted and proven screening tests for lung cancer that we believe will reduce the mortality rate, except for the ones we’re testing," Gohagan said. "If it turns out that spiral CT, as many suspect, is more effective at reducing deaths from lung cancer than chest x-ray, the public and practitioners will want to know this and make use of it in medical practice. If it is not, or if it turns out to contribute unnecessary risk because of findings that have to be followed but are not threatening cancers, the public and the medical practitioners would certainly want to know this information as well."
For more information about the NLST, see http://cancer.gov/NLST.
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